Date of Award

January 2023

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Shiyi S. Wang


ABSTRACTObjective: This study aims to evaluate the association between depression at baseline and presence of three sleep disorder symptoms (fatigue, daytime sleepiness, and insomnia) following 6-month hospital discharge in elderly COVID-19 survivors. It also aims to identify which other baseline patients’ characteristics or post-discharge factors may be associated with these sleep disorder symptoms. Methods: The participant datasets were obtained from VALIANT, a prospective longitudinal study of community-living adults aged ≥ 60 years who were admitted with COVID-19 to hospitals within the Yale New Haven Health System (YNHHS) from June 2020 - June 2021. Multiple logistic regression models were performed to predict the presence of sleep disorder symptoms at 6-month follow-up interview after discharge using depression status at baseline, and to explore other potential associations between outcomes of interest and study variables. Results: Out of 306 participants (mean age=70.8), 93 (30.4%) reported baseline depression. At baseline, 94.6% of those with depression reported fatigue, 90.3% reported daytime sleepiness, and 73.1% reported insomnia. Participants with baseline depression had adjusted odds ratios (aORs) of 2.03 (95% CI 1.10 - 3.75) for daytime sleepiness and 2.14 (95% CI 1.18 - 3.87) for 6-month post-discharge insomnia compared to those without baseline depression. No statistically significant association was found between having baseline depression and the presence of 6-month post-discharge fatigue (p=0.372 > 0.05). This study also found a statistically significant relationship between sex, race, education level and 6-month post-discharge sleep disorders. Conclusions: Pre-admission depression is associated with the presence of 6-month post-discharge daytime sleepiness and insomnia in elderly COVID-19 survivors. To avoid the long-term negative impact on patients experiencing sleep disorders, timely identification and interventions are important.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/10/2024